Event Pre-registration

Please enter the check code as shown (all uppercase letters)
:

Your name*:

Include the names of both riders here and the details of the second rider in the /Request/ box below

Male Female *

Your Date of Birth (d/m/yyyy)*:

Your Email Address*:

You will be notified of your start time by email

Contact Phone/ Request:

Distance Options

Default: 2-Up
SOLO

In consideration of the Australian Time Trials Association Inc. accepting my application to ride in this event, I agree that the association, its members and officials will not be held responsible for any personal injury or property damage or loss suffered by me. I also release the association from any liability for negligence.
I acknowledge that in time trials I will be riding at my own risk, usually on public roads with other traffic where I must obey traffic regulations. I further understand that time trialling is an endurance sport which requires a high degree of physical fitness and accept the risk that I may suffer illness or injury if I take part in such a sport while insufficiently fit or healthy.
I further agree to accept the association's rules for race conduct and understand where severe weather conditions or other hazardous situations occur before or during any time trial, the organisers have the right to cancel, postpone or otherwise modify the event and entry fees may not be refundable.
Finally, if I accept the loan of a timing transponder, I accept the responsibility for the return of the device in good condition at the end of the event and agree to reimburse ATTA for its loss or damage.

Sending this form implies the person named herein has agreed to the above conditions.